Memorial Hospital at Gulfport recently acquired a machine with a special magnet that has been shown in some cases to cure depression. It’s called a Transcranial Magnetic Stimulator (TMS). The concept and technology has been around for about 15 years or so. MHG is the first hospital in Mississippi to have such a therapeutic machine, which is also controversial.
TMS is indicated in the treatment of persons with depression who have failed to have their depression treated with a single medication used at any dose. The series of treatments involve applying a small magnetic arm of the device against one side of the head and sitting for almost an hour, five days a week, for six
to eight weeks. The only “side-effect” in some cases is a mild irritation on the same side of the head. Each session costs $400. A full-course of therapy costs $10,000 - $12,000, whether or not you have insurance.
Compared to medication, TMS’s success rate, relapse rate and cost is as follows:
Success Rate Relapse Rate Cost
TMS 0-50% 1 in 3 $10,000 - $12,000
Medication 65-80% 1 in 5 $248 - $1,400
The treatment is controversial among psychiatrists because the statistical methods applied to the approval of a new prescription drug was not applied to TMS therapy. It was only approved by the FDA after pressure was applied (political?) to approve it based on other less accepted “after-the-fact” statistical methods.
While no one is complaining about any of our hospitals acquiring new or cutting-edge technology, this particular purchase and the purchase of almost any new technology, raises the cost of health care and is a perfect example of the argument we’ve heard in the national debate on the rising cost of health care and the costs to Medicare especially. MHG hopes to obtain Medicare approval for reimbursement within a year. Multiply MHG’s purchase many times over with hospitals across the country and you immediately see the cost to taxpayers of a medical condition that in most cases, and without controversy, could otherwise be predictably and meaningfully treated with medication.
Our hospitals are continuing to grapple with balancing rising overhead with revenues. No one can argue about MHG, or any hospital, in seeking ways to remain financially viable. We’ve already seen one hospital on the Coast fail some years ago. Lord forbid if any of the remaining six hospitals on the Coast go under. But at some point, and this has been the crux of the argument in trying to rein in health care costs, the appropriate and reasonable use of resources will have to managed commiserate with what we can truly afford. The metaphor, a weak one at that, of managing the national budget like we would a family budget is applicable here. If a family continues to eat every night at Mary Mahoney’s, Jazeppi’s or Vrazel’s they will be well fed and well nourished but it won’t take long before they outspend their budget for food. There are many other countries that have solved this problem of utilization of medical resources beyond what is affordable and have national health outcomes that are better than ours.
At some point, like that of a family budget, at the risk of bankrupting Medicare and straining the national bank, someone in the family, or some entity will have to determine what is economically sound, appropriate and reasonable -- not to mention what is affordable. At some point limits have to be respected.
At the risk of sounding like a medical heretic, for doctors and patients to be absolutely free to order everything and anything regardless of cost is an unbridled freedom that will eventually result in a collective calamity that none of us really desire. I hear you thinking, “This is sounding like rationing.” Perhaps, but patients and doctors have been experiencing “rationing” by health
insurance companies forced on us for over 20 years in levying restrictions on certain tests and x-rays in the interest of increasing profits for CEOs and Wall Street investors. No matter how you slice this pie, incentives to limit or restrict the unbridled use of health care resources at some point will have to kick in – to the benefit of all. How this should be done is certainly an issue for debate. But like it or not other countries have done it. Why can’t, or shouldn’t, we? To shirk at the idea that we “shouldn’t be like other countries” smacks of a cowboy attitude that leaves reason and sound judgment at the front doorsteps of a solution -- and more or less handcuffs our ability to make needed reforms.
In a state ranked No. 1 in those who are paid minimum wage, I’m not sure how many Mississippians in this area will benefit from this particular technology, but at least it’s another option for depression therapy if your commercial insurance company covers it, or you have 10 grand lying around, or you happen to be a Medicare beneficiary.